Episode 3 A&E on the Road

Racing to treat a patient in need of critical care.

Yeah, 5-2, can I have a crew, please?

This is the West Midlands Ambulance Service.

This could've been a fatal incident, 100%.

A dedicated team of doctors and paramedics.

-Hi there, your ambulance.

-Don't like it when they cry.

They respond to a million 999 calls every year.

SHE GROANS Fighting to save lives.

Basically, went straight up in the air, crashing down.

Because some emergencies are so severe...

-He's fractured his femur.

-..treatment must begin...

-Take a deep breath in, mate.

-..out on the road.

I am grateful to every paramedic.

If I could give him a medal, I would.

AMBULANCE SIREN

Today, a near fatal motorbike crash.

I basically went straight up in the air, about 20 to 25 feet.

A toddler needs help after a seizure.

It's a real pressure, dealing with children.

And the smaller they are, the more pressure you feel.

And John treats a woman in unbearable pain.

I've had very dark days - and I have cried and cried.

AMBULANCE SIREN

Working alongside the West Midlands Ambulance Service paramedics

is a voluntary organisations called BASICS.

BASICS stands for the British Association

of Immediate Care Specialists.

-BEEP

-Roger, many thanks. Out.

It's purely charitable, what we do. It's all in our own time.

Just aiming to bring the skills that we've learned

and use every day in the hospital,

and taking those out to work alongside paramedics,

and just assist them in these more complicated injuries.

OK, we're going to a two-year-old girl,

who's been found by her mum, fitting.

The most common cause of fitting in young children is having a high

temperature, or being diagnosed with epilepsy.

Around one in 50 children will have a febrile convulsion or fit

before they turn five.

-How do we get in to you? Round here?

-Round this way.

-Okey doke.

In the worst case scenario, a fit can be life-threatening.

INDISTINCT SPEECH

Ben needs to quickly assess the toddler.

-OK, hello there.

-Hiya...

-How are we doing?

INDISTINCT SPEECH

Has this young one been diagnosed with fits before?

She's had a fit before, cos of a high temperature.

-OK.

-But she hasn't been diagnosed with epilepsy or anything like that.

OK. Let's have a quick...

'Ashanti's temperature was way above 39 degrees,

'so she was very, very hot.

'Much too hot for a baby.'

And that's almost certainly why she fitted.

So what was she doing earlier?

She was lying on the sofa with me, then, next minute,

-I just noticed that she was fitting.

-OK.

Fine. And when you say fitting, what do you mean by fitting?

-Foaming from the mouth a bit.

-OK, OK.

-Shaking.

-Shaking.

And she's stopped shaking since then.

-Yeah, she's stopped shaking.

-How long did the shaking last?

-About ten minutes.

-Big stretch.

Hello there, sweetie.

Aren't I horrible?

Let's pop your finger in there.

So, sometimes people do fit again, OK?

So don't be worried, she's got the right people here now,

and we've got an ambulance on the way, and we will be going in. OK?

It's a real pressure, dealing with children.

And the smaller they are, the more pressure you feel.

ASHANTI BREATHES HEAVILY

Well done. Thank you very much. So this is just a little bit of oxygen,

because her oxygenation isn't perfect.

It's nothing that I would be worried about, but I can...

Oh, look at that.

One of the causes of a fit could be not enough

oxygenation in the brain. So we give it for that reason.

The other reason is we want to make sure there's plenty of oxygen

getting to the brain,

because there's increased brain activity during a fit.

I've never seen a child have a fit.

Oh, dear. It's not nice, is it? Especially not when you're Mum.

All right.

All right, sweetie... Hello there. Let's just leave you where you are.

Well done.

The ambulance team arrive and Ben updates them on Ashanti's condition.

She's coming round a bit. She's eye-opening.

We'll just see what the BM is.

Do you mind taking over the head end and just...?

She's maintaining her own airway.

The respiratory rate's 24, erm, and GPS is picking up as we go along.

She's just eye-opened spontaneously.

I'll just have a quick word with your crewmate

and I'll give him a hand getting

-everything prepared so we can get her into hospital.

-Smashing.

Concerned Ashanti may have another fit in the ambulance,

the crew need to be ready to deal with it.

We want to have intravenous access, so we can give the necessary drugs

in order to stop any further fitting.

But hopefully, if we can get her temperature down,

we can reduce the risk of that.

-ASHANTI CRIES

-OK.

Ben, if you... The head end is at the far end,

so if you want to lay her down here.

That's great. And if you want to sit next to her.

OK. Well done.

Ashanti's dad, Rich, has rushed home to be with her.

What you been doing? Hiya. What's happened? It's all right.

Sometimes they get a bit confused after a fit,

so she might not be recognising you particularly much,

but that's just cos she's had a fit. OK? Nothing to worry about.

What's happened?

Now, I'm going to try to put a little plastic needle in her hand,

so if you want to concentrate on leaning over that side,

so she can see you over there.

-Asha.

-OK.

-Over here, babe.

-Well done. Well done.

-Well done.

-OK.

-It's all right.

-I need to pop a cannula in.

If she is going to fit again, I need to be able to give her drugs.

Erm... And the only way we can reliably give drugs

is by giving them into her vein,

so if we can easily get access, we'll get it.

OK, so a horrible scratch coming up for her, so...

VOICES TALK OVER EACH OTHER

Nasty scratch.

ASHANTI CRIES

-OK, my love. OK.

-It's all right.

A bit of a high temperature and a bit of a high sugar,

so what we're doing, we'll just run her in, just to make sure that everything's OK.

Erm, there could be 101 things, especially with children.

They can do really well and then crash really easily,

but it don't seem the case, so it's all just playing it safe for the moment.

AMBULANCE SIREN

What's our ETA?

BEEPING

-It's OK.

-Ooh, dear.

Eight minutes. Brilliant.

She has a temperature, initial temperature of 40,

which has come down to 37.8 now.

She hasn't fitted since

and her level of consciousness has improved since then,

so she's now eye-opening spontaneously.

A little bit confused, not particularly attentive to Mum.

But I think she's probably someone who'd benefit

from either coming to resus or the children's area,

just to be kept an eye on, maybe some intravenous paracetamol,

erm, you know, et cetera.

Our ETA is six minutes from now, OK?

'Mum was really quite distressed by this,

'but she did an absolutely excellent job.'

Yeah, go on, follow alongside, hold her hand if you want to.

'I want to reiterate to her what a great job she did.'

At Royal Stoke University Hospital,

Ashanti is taken into the children's area.

-Hello, hello, hello.

-Hello.

-How are you doing?

-Hiya.

This is young Ashanti.

-She's two years old.

-Mm-hm.

She's had one previous episode of a, erm, febrile convulsion.

ASHANTI CRIES

-Oh, dear.

-Oh, no...

I don't like it when they cry.

Hopefully she won't fit again,

but if she does, she's in the right place.

They've got better lighting,

they've got full equipment, they've got more pairs of hands.

So if she fitted again,

we'd be in the right place, pop some IV access in

and give her any appropriate drugs.

-OK? Right, take care.

-Thank you for helping.

-Bye-bye.

Today, she was just lying down on the sofa, behind her mum's legs.

Her mum felt a couple of kicks, thought she was playing,

and she turned around and saw that she was having

a convulsion...

and then got on the phone to me,

and I had to go, get back sharpish, type of thing.

So...scary. Very scary.

You know. I'll have a little cry about it later.

Off camera, of course.

The good news is that Ashanti was given the all-clear

and discharged from hospital the next day.

AMBULANCE SIREN

The rapid response vehicles were set up

because we can get through traffic quicker.

Every second counts when somebody's critically ill,

and we can get there and stabilise the patient

before the ambulance gets there.

I used to have my own business, I did hair and beauty,

and also I worked for Richard Branson on Virgin Atlantic.

I was an in-flight beauty therapist for six years.

It's not much different, I still deal with the public,

erm, still have interesting days,

but unfortunately, not going to the exotic locations that I used to.

Today, Simone is heading to the scene of a motorbike accident.

We're going on the way to Kidderminster,

and it's a motorcyclist versus a car.

All the information we have at the moment is the car driver

is very shaken and the motorcyclist seems badly injured.

So, obviously with the nice weather, a lot of motorcyclists are about,

especially on this stretch of road.

It tends to go out into the country a little bit more.

It's a fast road and it's obviously very straight,

so we do have quite a few.

Hi there. Who is the driver of the vehicle?

Were you on your own? Are you OK? Yep.

A consultant paramedic and a passing nurse are already on scene.

The worst thing to see is somebody on the floor and they haven't moved,

cos most people will get themselves up.

But if you see a motorcyclists lying on the ground, you know,

you fear the worst.

Whereabouts is it? Is it below your elbow?

-On the elbow.

-On your elbow.

-Just on your elbow.

We're going to have to cut your jacket, OK?

Can I move this arm? I'm just going to put some sticky dots on...

'We checked his full vital signs to make sure there was no other injury,

'cos it can be distracting, cos you're in pain,

'but other things, more serious, are going on.

'Neck, back-wise, spinal injuries.'

We're looking, erm,

obviously for life-threatening injuries, for bleeds.

The biker was on his way to work when the accident happened.

As I came round the corner,

I saw a car.

It was indicating to turn,

so I started to slow down a little bit.

And as I got to the first entrance of the pub, he decided to go.

From what I've been told, when I impacted,

I basically went straight up in the air, about 20 to 25 feet,

and then I came crashing down,

headfirst, straight into the tarmac.

I don't remember the impact.

I remember looking up and seeing blue, bluey-grey sky.

The next thing I remember is waking up to the paramedics working on me.

Do you remember everything, Simon? Everything that happened?

-Not exactly, no.

-Not exactly.

INDISTINCT SPEECH

HISSING SOUND

Still no pain anywhere else?

-Just my left arm.

-Just your left arm, still your left arm, all right.

When we go into a high impact job,

we do expect broken-boned people can bleed

and lose excessive amounts of blood,

so we are very aware that we do need to make sure

that this isn't going to cause

catastrophic haemorrhage for the patient.

There's a bit of blood on your...

coming from your jacket. Can you ascertain where that's from?

I'm cutting your jacket.

I was just saying, he's got the right kit on, chaps.

-He has...

-We were just was saying that as we were coming.

'I do remember hearing the paramedics talking.

'The things that I could hear didn't sound good.

'I was concerned about internal bleeding.'

Although I've got my bike gear on,

there is the nickname of bike gear as the body bag.

To hear the Air Ambulance in the sky,

when I heard that, I was quite scared for how bad, injured I was.

I thought at first it was just my arm, and just cuts and bruises.

But to hear the Air Ambulance,

it made me think that I'd had a lucky escape.

All right, sweetheart.

OK.

Do you think you lost consciousness, at all?

-You don't know what's happened.

-Don't worry.

The paramedics decide to take Simon to hospital by road ambulance.

Hi there.

Just can we get the stretcher? And we'll get the thing and everything, yeah.

-That's great.

-That's great.

-It's really, really hurting.

-OK?

-All right.

I'm going to give you some oxygen, that will help.

It is going to be a bit painful,

cos we're going to put this splint on your arm, Simon.

-That's the morphine. Keep breathing that gas.

-Deep breaths.

'Any broken bones that we find, we want to immobilise them.'

It will help with the flow of oxygen, the flow of blood.

Unfortunately, it is going to hurt.

-SIMON GROANS

-Sorry, sweetheart.

-Sorry.

-Deep breaths.

With Simon, there was a high probability that he might have spinal injury,

so we have to immobilise him,

and then we use head blocks and try to...

Limited movement for him, so there's no more damage,

if there was any damage to his spinal cord.

-OK. Ready?

-Yeah.

-Steady, roll.

Well done, Simon. Well done, well done, well done.

When he gets to hospital, Simon will be given a full body scan.

We're just going to lift you now, Simon.

So if you just put your arm there, that'll be great.

-OK? Ready?

-Ready, steady, lift.

There we go.

Simon suffered some serious injuries,

but something positive also happened

because of his accident.

Prior to the accident,

me and my wife were going through a separation.

The day of the accident,

it made me realise, and I remember being...

laying on the road, just asking for my wife.

I heard that he'd been in a full bike accident and he was going

for a full body scan. I was thinking, I need to get to

the hospital, I need to get to him. When I finally got there,

I just couldn't believe the sight I saw.

I'll never get that image out of my head,

where he was covered in blood.

His mouth was just... You couldn't see his teeth for blood.

When my wife turned up, she just walks in,

takes my hand and gives me a cuddle and says, "You're going to be OK."

And it was the words I needed to hear.

Scans revealed no internal bleeding or spinal damage, but Simon has

shattered his elbow in five places.

He believes he's lucky to be alive.

Looking at my bike gear,

it looks like I've put my left arm out

against my forehead, which saved my life.

Although I've broken my elbow,

if I hadn't have put my arm up,

then potentially, I could've bent my head back

and snapped my neck.

Sorry, sweetheart.

OK. Whereabouts is it hurting?

My arm is really, really hurting.

-RACHEL:

-Just seeing it, seeing all that blood.

-Going to give you some oxygen, that will help.

-I knew it was bad...

Seeing it like that is...

-Oh, my God.

-SIMON GROANS

Sorry, sweetheart. Sorry.

The accident may have saved their marriage.

Whee!

Choo-choo!

Yeah, we're going to try to make it work for our daughter and for ourselves,

cos it's obvious that there's still a lot of feelings there.

It has brought us closer, put things into perspective with

what's important, and hopefully we'll see if we can sort things out.

Obviously, I won't be getting on another motorbike again,

because of Mary.

I don't want to risk the next time something happens

to not survive it and then leave Mary without a dad.

AMBULANCE SIREN

I have been in the Ambulance Service for 16 years now.

I've been a paramedic for just nearly ten.

The worst thing about being a paramedic, it's the strain

within the service. The amount of jobs that we do.

They're escalating, they're getting bigger and bigger by the day.

The best thing, it's the ultimate, it's saving someone's life.

Being there and the actions you do actually saves someone's life.

I don't think there there's any other feeling that you can have.

In 16 years, it's done me fine, fingers crossed.

Today, John is going to treat a woman experiencing extreme pain.

Currently on our way to a lady who is suffering with severe

abdominal pain. Said it's going into her back and into her groin.

Could be a multitude of different things, really.

Anything from kidney stones to a water infection.

We'll see what the history is before we get there

and see if we can help her out.

-Down here.

-John's a regular visitor to this patient.

-Oh, hello. I've met you before!

-HE LAUGHS

So, what's been going on again? Remind me.

-I've slept since.

-Keep getting this pain in me stomach.

-Yeah.

-Me groin and me leg.

-OK.

-I keep having flare-ups.

I was great, I've been down the park with the kids,

I've done nothing strenuous, have I?

It's just come on with a vengeance.

SHE GROANS

'It started off three years ago.'

I had this really intense pain.

I thought it was appendicitis,

and so did the doctors when I got to hospital, but it wasn't.

They did every test imaginable.

I was in there for four days and they couldn't find out what it was.

And after that, it seemed to be every week

I was calling an ambulance for this pain, excruciating.

I can't explain how bad it was.

I'm in agony.

I've had three children

and I would rather give birth five times than go through that pain.

-And it comes in spasms.

-BEEPING

Oh...

It's me back.

-Right.

-I've lost two discs in me back.

-Right.

-And me bones are crumbling.

-And it's dust hitting the nerves.

-BEEPING

-OK... It's all right.

-Ah...

Wendy's condition is chronic.

All John can do is offer her relief from her pain.

Get a cannula into her hand.

-Give her some morphine, we'll pop up to...

-INDISTINCT

-This lady... She's known to me.

-HE LAUGHS

She's, erm, had a long standing issue with this, problems,

with the pain going down to her arm.

She's waiting to see the pain clinic.

Basically, long-term chronic pain relief.

-Needle in.

-Ah...

-BEEPING

Ooh...

Let's have your right hand, sweetheart.

Yeah, but wait till this goes.

Ooh!

BEEPING

-Sorry.

-That's all right.

I hate these.

'You do get used to seeing people in pain.

'That's definitely part of the job.'

It's worse to deal with when you can't do anything about it.

We've got quite significant pain killers we can give intravenously,

but when you've given all that you can give and they're still in pain,

it's quite hard to deal with.

You can have...

All you can offer them is sympathy, really.

It shouldn't take three years, should it, to be pain free?

The problem is, we don't really know what's causing it, do we?

-No.

-If you don't, it's...

When you don't know what's wrong with you, but you're in constant,

constant pain, you do get angry and frustrated.

You know, what the hell is going on?

Am I going to die? And you do think that a lot.

I've had very dark days - and I have cried and cried,

and it's an awful thing to say to your children,

but I've even said to my children,

if this is the rest of my life, I don't want it.

BEEPING

How are you feeling now?

-A bit better.

-Anything kicking in?

Anything making you feel funny?

-Sorry?

-Anything making you feel funny?

No, I'm all right. Just itching.

-Just my arm's itching.

-And that's normal for you?

-Yeah.

It's instant, as soon as the morphine goes in, me arm itches.

It's ever such a funny sensation.

-What is?

-Oh, you can feel it all up here.

BEEPING

It's a good job I've hit the right one, then.

WENDY LAUGHS

18 minutes after being given the morphine,

Wendy is on her way to hospital, to be given even stronger pain killers.

And from that day on, things finally started to improve.

I changed doctors - and she was marvellous,

and got me to see different specialists.

And things started to really move, then.

And I had an MRI scan, and I finally had a diagnosis.

After three years. It was amazing.

WENDY LAUGHS

I've been diagnosed with disc degeneration.

After the diagnosis, I went in for a procedure, which I think,

hope, has worked. I had injections in my back, into my nerve endings,

and I've only had the pain once since.

-So, we might be getting there now.

-WENDY LAUGHS

It feels absolutely amazing.

It really does.

I feel like I've got a life again,

cos my life was put on hold for three years.

In those days, I just felt that life wasn't worth living.

I am so grateful to every paramedic I have seen.

They are worth their weight in gold.

They really are. If I could give them a medal, I would.

WENDY LAUGHS

AMBULANCE SIREN

The West Midlands Ambulance Service has 100 rapid response vehicles,

all crewed by single paramedics with advanced skills.

We drive a fast car,

and we tend to get there first on scene.

We're used in different ways. If it's a real serious job,

they will respond us, as well as an ambulance.

With a job with less priority,

Control will tend to wait on our say,

so if we need any backup.

Today, Kathryn is on her way to treat a teenager,

suffering from a debilitating illness.

We've got a 15-year-old with Crohn's disease,

and he's got severe abdominal pain.

Hello!

-Straight through?

-Yeah, straight through.

-There you go.

-What's been going on, then?

Hello, young man.

-He's been vomiting.

-Right.

-And he's just not well today.

He said, "Mum, I'm not well, I don't feel well."

I didn't feel right that day,

cos I got out of the car and I was sweating.

I just felt dizzy. I went as white as a ghost.

And then, all of a sudden, I just started being sick.

He's got Crohn's disease.

-Yes?

-So, it's in his stomach, his large colon and his genitals.

Right. I'm just going to do a few little observations on you.

Is that OK? Yeah? Kyle?

If we had a score of one to ten, one being a little pain,

ten being a massive pain, what would you put it at?

-Ten.

-So, it's that bad. All right.

The pain felt like someone was

just repeatedly kicking me in the stomach, over and over.

I gave Kyle a drug called Entonox,

which is basically gas and nitrous oxide.

Have you ever had any gas and air before?

Entonox, yeah?

It is brilliant as a first-line pain reliever.

-Is that OK?

-Mmm...

-Is that OK, Mum?

-Yeah, that's fine.

-OK.

And then, we'll get some little observations done on you.

All right.

Let me just get you some transport.

52, thank you, we'll have an amber response, please. He needs to go in.

-What was that, mate?

-I'm really cold.

Oh, no. Let's get you covered up a bit,

and then we'll do some observations on you. Has it been this bad before?

It has.

Kyle was diagnosed three months ago, after suffering for two years.

All right, and just have a...

You need to make a noise.

-RASPING SOUND

-That's it. That's the noise.

When a child is quiet,

it's usually an indication that they're poorly.

Keep going with that. It might make you go a little bit light-headed,

sweetheart, but it'll help with that pain, all right?

And with Kyle, he was listening,

and he was talking to me, but not really making conversation.

But as he was taking the gas and air,

he started to relax a lot more and talk to me a lot more.

You're not supposed to be bad in the school holidays!

It's term time to be bad!

-Oh, do you? Because of your condition?

-Yeah.

-Dear me.

I'm just going to pop this in your ear, my love.

Keep sucking on that.

HISSING SOUND

OK.

Temperature's OK.

Is it just taking the edge off it a little bit for you?

Suck a bit harder.

That's better. That's better.

All right. It will help.

-All right, Mum?

-Yep.

OK.

I've never seen my son like that, ever.

I thought I'd lost him.

I always say, trust Mum's instinct, they know best.

And she knows that Kyle's quite poorly today,

and she's had the good sense to ring an ambulance,

so we're going to pop him up the hospital.

All of his obs are OK,

but he's not OK, so we need to get this sorted.

The Entonox really seemed to help him and relax him.

By the time the crew got there,

he was a lot more relaxed in his stance, as well.

You could see. You've got one of the best paramedics in the world here.

-All right, then. Hello.

-Hiya.

This is Kyle. He's always in pain. Right?

-But today, he's been in a lot of pain...

-Vomiting...

And he's been vomiting.

Not while I've been here. All of his obs are perfect.

OK?

Lost quite a bit of weight.

Now the crew are here, we're going to go down the line of giving him

some paracetamol, but in a drip.

-Yeah.

-Is that OK with you?

-Is that OK with you?

-As long as it gets me better, I'm happy.

-That's it.

-It will help take the pain away and then we'll get

the doctors to get you better, all right? Just pop them in.

-And the other one.

-VOICES TALK OVER EACH OTHER

It's quite hard on your bottom.

-All right.

-All right.

It was awful. He couldn't stand.

He didn't know where to go.

He was so thin.

He'd lost so much weight.

A bit of a bump, OK?

Backwards all right?

Nice and steady.

Ready?

Bring your feet up.

At least I've got some smiles now.

Smiles from Kyles!

Later at hospital,

they found the source of Kyle's pain was not his Crohn's.

They took bloods from him, they came to us and they said

Kyle was given a tablet called Azathioprine, for Crohn's disease,

but the trouble was, there is side effects with this drug.

Now, it doesn't affect everybody, but unfortunately,

Kyle was one of the people that it does affect.

When I got to the hospital, they found what was upsetting me,

which was the tablets.

They gave me morphine, paracetamol,

and everything, cos I was in too much pain.

The drug that Kyle was on for Crohn's

caused him to have inflammation of the pancreas.

It can be fatal if it bursts.

So, in one respect,

I was glad Kyle collapsed, because everything came to a head then.

Thank you to them for finding it, otherwise it could've been fatal.

Cos, as my pancreas was swelling, it could've burst,

which could've killed me.

He was lucky. He was so lucky.

Kyle continues to work with consultants

at Birmingham Children's Hospital

to find ways of dealing with his Crohn's.

How have you been?

It could be better.

All the swelling's come back,

the redness, and it's weeping again, so...

-OK.

-And it's hard to walk again, so...

-OK.

-..I don't know what to do.

He's got a great group of doctors

who are helping him, and they get their heads together,

and I know somewhere down the line, they will sort him out.

I'm pretty confident that day will come.

It might take a few more years, but at least it will be gone,

and I just wish I could be normal, like everyone else.

AMBULANCE SIREN

More than 3.5 million people in the UK are living with diabetes.

There are quite a large amount of diabetic patients

within the population, but people manage themselves.

They know how to manage it on a day-to-day basis.

We only get called when it becomes a crisis,

when the blood sugars are too low, or too high.

For diabetic patients, the best thing is routine.

You can do whatever you want, really, in your life,

as long as it's kept in a routine.

John's in Stourbridge on his sixth job of the day.

We're off to a 76-year-old lady.

Just says she's got diabetic problems at the minute.

There's no further details.

I'm assuming the call's still in progress,

and they're trying to ascertain what's going on.

We've just had an update come through.

The lady is what they call a hypo,

so her blood sugar's gone too low for her to function properly.

If the blood sugar just keeps dropping,

basically, the body shuts down.

'Just ahead, turn right.'

So it really just depends quickly we can get there.

'You have reached your destination.'

Left untreated, a hypoglycaemic incident, or hypo, can be fatal.

-Hiya.

-Hiya.

-How we doing?

-She's managing to swallow.

-Excellent.

-So I'm giving her a bit of Lucozade.

-Super-duper.

-But I'm just wondering, you know, whether she's had a stroke.

-OK.

What we'll do, because they present in a similar way,

-we'll make sure the blood sugar's all right and deal with that.

-OK.

The best way to tell the difference between a stroke and a hypo

episode is basically we do a blood sugar test.

So a pinprick on the end of the finger.

If it's below four, we know the patient is hypo,

so we treat them for that.

How often does she have a hypo?

She hasn't had as many recently, but she's not been very well.

-She's on antibiotics for pneumonia at the minute.

-Right.

We'd just come up to visit my mum.

My dad said she'd been asleep for a couple of hours,

so my daughter came up to see how she was,

and she couldn't wake her.

All right. I'm just going to do your blood sugar again.

Come here, chicken. There we go.

Sharp scratch, my darling.

-2.1.

-That's a bit better.

-It was 1.6 when I did it.

-Okey dokey.

With the reading below four, a stroke is ruled out.

John prepares to raise Pat's blood sugar levels.

Has she had a Glucagon injection lately?

-No.

-She's quite well managed, then?

Well...

We can give an injection in the arm called Glucagon,

which is a synthetic hormone, which releases the body's own stores.

Well done, darling.

We can also give an intravenous drip of glucose 10%,

which is basically the body's rocket fuel.

As long as it's blood sugar, we know we can fix it here.

That's always the bonus with it.

That's all right.

Her blood pressure's fine, oxygen levels are OK.

Her ECGs are all looking good.

How we doing, Pat?

Are you with us yet?

-Is there a hint of realisation going on here now?

-Yeah.

Filthy looks.

We've given her the injection now,

so hopefully it will start to build up,

but obviously as the brain's getting more oxygen into the system,

Pat's becoming more aware of everything.

But Pat's blood sugar level has dropped, rather than risen.

0.9. You're going the wrong way!

Are you trying to play me up?

So John decides to try a different method.

Because the blood sugar's still going down,

so we'll just pop a needle in her vein

and give her some glucose intravenously,

and we'll take it from there.

Come on then, trouble.

I've got a sneaking suspicion,

-it's because she hasn't been eating well.

-Yeah.

Before John can put in a drip of more concentrated glucose,

Pat starts to come round.

-You're cold? We've got you talking.

-That's all right.

-That's better.

Well, I came up here to have a sleep.

-Yeah? You did.

-You did well, you succeeded!

What's been the matter with me?

-You've had a hypo.

-A hypo?

Yep, a good one this time.

John re-checks Pat's blood sugar levels.

She's sweating to death.

Oh, I was sweating.

-The blood's running.

-5.5 now.

-That's better.

It's taken 23 minutes for Pat's blood sugar level to return

to a healthy level since John first tested it.

-How long have you been here?

-Oh, hours!

When we've given the medication and they suddenly come out of this

unconscious and confusing state and look at you, it's quite nice,

because someone could die from that, but you've treated them,

and nine times out of ten, they're lovely people.

They're nice jobs to do.

Lift your arms up for me, Pat, can you? Excellent.

Pat's blood sugar has miraculously spiked up to a normal level.

We're going to give her something to eat, jam sandwiches and sweet tea,

hopefully that will bring the sugars up even more, so...

15 minutes later, Pat's almost back to her old self.

I can't ever remember anything like this.

I've had a hypo, but it's only like a small one, as you'd say.

She doesn't do what she's told,

but she doesn't seem to think that it's a problem.

She can eat when she wants, and drink when she wants,

and not check her blood sugars when she should do.

She's back to normal again now, making jokes and laughing,

so, that's my mum back again, yeah.

Initially, I thought I was going to have to give her some intravenous

glucose, because that blood sugar didn't come up,

but then she just suddenly spiked, and perfectly back to normal.

She admitted she hasn't been eating very well

and taking her meds as she should, so she's going to speak to the GP,

and get the district nurse to sort her out.

The daughter's a nurse as well, so we'll leave her to sort her mum out

and give her a telling-off!

But, yep, ultimate result was ideal.

Four months later, Pat has recovered from her episode,

but it seems she still hasn't learned her lesson.

I mean, she's been diabetic for a long time,

and she's got very blase with things that she eats

and how often she does her blood sugars.

Very often, she'll have a piece of chocolate,

and instead of having one piece, she'll have three pieces,

and the same with biscuits,

and she's very partial to a piece of cake, now and again.

John, the paramedic, was fantastic.

He was very reassuring.

He spoke to Mum continuously.

Without John, definitely, Mum wouldn't be here.

It was touch-and-go at that point, because her blood sugar was so low.

So it was the quick response of them getting round here,

and being able to act on her blood sugar quickly,

saved her life.

The profession of a paramedic is all about helping people.

When the elderly call for us,

it appears that they're quite brave-faced sometimes.

They seem to shrug off the sort of problem that they have at that time,

their long-term condition.

They almost treat us as sort of,

or treat themselves as being a hindrance to us,

which certainly isn't the case.

In Stourbridge, paramedic Ste Hill is working the late shift.

We're on the way to a 999 call to a gentleman

who looks like he's fallen on the floor and he's got a back injury.

The chances are he's just tumbled at home,

but particularly in the elderly, there's a chance of fractures,

which is greater than it would be in a healthier, younger, fitter person.

Hello?

Ambulance.

Hello there, young man.

Right, what's your name, mate?

-What's your name?

-Leonard.

-Leonard, hello. Do you like to be called Len?

-Len.

-Len. Hello, Len.

-What happened to you?

-I've fallen down and I can't get up.

-I've got a dicky leg, won't support my weight.

-OK.

Where have you fallen from, Len?

-Just off the chair.

-Have you injured yourself at all?

-No.

-Have you got any pains anywhere?

-No.

-All right. What I'm going to do, if it's OK,

I'll check you over top to bottom,

-to make sure you haven't hurt yourself.

-Fair enough.

-OK, mate.

All right, anything on your head at all?

-No.

-Any pain down your neck or your back?

-No.

Can you pop your legs flat on the floor?

-Very awkward.

-Can you move your legs for me?

Can you bend them up? OK.

All right. Let's just have a feel of your wrist.

I've got COPD and a dicky heart.

All right.

Did you just slip? Is that the reason you ended up on the floor?

OK.

COPD stands for chronic obstructive pulmonary disease,

a lung condition which makes breathing difficult.

All right, then. Thank God for that.

No problem. Can we do a few observations?

Check your blood pressure and whatnot?

-No problem.

-OK, mate.

Following Len's fall, we've got to rule out with Len's age,

any further injuries or medical conditions

that maybe could have caused his fall.

We're just going to do a routine sequence of checks now,

and make sure that everything's as it should be.

All being well, he'll stay here, I don't think he'll go to hospital.

OK, mate, it's just going to tighten your arm, OK.

Just pop these on your wrists and your ankles.

Right then, Len, this machine picks up any big movements,

so I just want you to relax for me, OK?

That's OK. Everything's OK.

We've done a full set of observations, everything is normal,

normal for him.

His ECG, his blood pressure, his oxygen levels, everything's good.

I think it's just a case now of making sure he's happy here at home.

-All right, Len?

-Can't grumble for 86.

It turns out that Len's fall was down to a war injury.

I got wounded in the Army in Korea

in that knee,

and it won't bear any weight.

Yeah. How did you get injured in Korea? What happened?

I was a clerk, believe it or not,

and the Brigade Major came to me and said,

"Corporal, can you read a map?"

And I said, "Yes, sir."

So he said, "Right, take these two trucks

"to 1st RAR and 2nd RAR."

-Yup.

-Which was up north,

where the Nationalists was,

and we was going across country to 2nd RAR

when the Chinese opened up with a heavy machinegun.

And they killed the driver.

-Yeah.

-And the round bounced off a rock,

and a piece of it hit me in the knee.

A piece of the rock, or a piece of the round?

-A piece of the round.

-Oh, right.

I drove the wagon myself up to 2nd RAR,

even with a bad leg.

-Were the Aussies grateful that you got the vehicle there?

-Oh, yeah.

Yeah? Did they know the trauma you'd gone through to get it there?

-I didn't tell them, did I?

-You kept that to yourself.

I told them about the poor driver being killed.

-Yeah.

-And falling out the wagon.

Yeah, of course.

I think you want a cup of tea, don't you?

-I'd love one.

-How do you take it?

-Three sugars, but not a full cup.

Three sugars, but not a full cup.

I dread to think how much sugar you'd have in a full cup, then!

Well, I've got a sweet tooth!

Let me get the kettle on.

Part of being a paramedic is how make a good cup of tea.

Our job's not always about sort of, like, patching up the injured

and really unwell people,

it's quite nice having a chat to the senior generation,

because they've got lots of life experiences.

I think he's enjoyed telling us the tale,

and we've enjoyed listening.

So it was nice to have a chat to somebody and you know they're OK.

Here you go, Len, tea's up.

Sweet, three sugars.

All right, Len. Lovely to meet you.

All right. I'm glad you're OK.

-OK.

-That's a fair old handshake.

You enjoy your cup of tea, all right?

-Yes.

-Goodnight to you.

-All right, we'll lock up as we leave. Bye-bye.

-Goodbye.

That was quite a nice story.

He's sustained an injury, and that's how we've come to meet him tonight.

So, obviously, he's survived the injury,

but that's how we've crossed paths tonight,

an injury sustained in the Korean War.

Sadly, seven weeks later, Len passed away, peacefully.

His family were happy for his story to be told.